The Chief Officer, ​Date:

United Bank of India,

Personnel Admn. (O.E.)Divn,
Head Office.

Sir,

​Through:​ ​Branch Manager, Bishnupur Branch, Dist: Bankura, Pin: 722122, W.B.

​Re:​ ​Issuance of “No Objection Certificate” for acquiring Indian Passport.

In reference to the H.O.Circular No. PA(OE)/MIS-86/07/OM-119/2005 dated June 07’ 2005, I am

submitting herein below the necessary particulars for issuance of “No Objection Certificate” for acquiring
Indian Passport.
1. Name (In block letter) SHUVAJOY CHAKRABORTY
2. Father’s Name Bijoy Chakraborty
3. Residential Address Nu-mans Park
P.O. Pailan, Kolkata- 700 104
4. Date of joining in the service in the Bank 10.06.2013.
5. S.P.F/A/c. No.
6. Designation Assistant Manager
7. Present Place of Posting Bishnupur Branch, Dist: Bankura, Pin: 722122, W.B.
8. Leave position (in details)
9. Name of the country to be visited United States of America
10. Purpose of visit My brother is going to the University of Texas, Arlington,
USA on 12.08.2015 for undergoing Ph.D programme.
Thus, in case of any emergency, I should have passport
ready in my hand though I have not immediate plan for
going to USA.
11. Whether any relative resides at the place of At present there is no relative at USA. But, from
proposed visit. If so, name and address of 13.08.2015, my brother will be there at the University of
the relative to be furnished. Texas, Arlington, USA till completion of his Ph.D
Programme.
12. Approximate date and duration i.e. period Can’t be ascertained at present but that must be as
of visit. minimum as possible.
13. Source of fund. Salary savings of me or/and that of my father.
14. Source of obtaining foreign exchange When required, foreign exchange will be have in
(Particulars in details for obtaining foreign exchange of INR from SBI, IIM Joka Branch,
exchange, Bank’s name and address are to Kolkata-700104 or from UBI.
be furnished.
15. Whether he/she previously obtained
visa/passport to visit foreign/neighbouring
country and if so, particulars of such No.
journey, availing of foreign exchange and
period of visit are to be furnished.
16. I hereby declare that:

a) I shall join duties on expiry of the sanctioned leave.

b) I shall keep Regional Office/Head Office posted with actual period of journey, name of the
country visited, availment of the foreign exchange for the purpose and details of my family
members accompanied with me within 30 days after completion of the said journey.

c) I shall return back the “No Objection Certificate” to you within 30 days from receipt in case the
same is not deposited to the concerned authority.

Date: (Shuvajoy Chakraborty)

Assistant Manager, United Bank of India,
Bishnupur Branch, Dist: Bankura.